非特異性腰背痛是臨床常見問題,約佔腰背痛病例的80%至90%,其特徵是缺乏明確的病理結構損傷或特定病因,通常由生理、心理及社會因素交互作用引起(Koes, Van Tulder & Thomas, 2006)。由於難以精確識別疼痛來源,研究建議治療不應過分追求病因診斷,而應首先排除嚴重病變,如惡性腫瘤、骨折、感染或馬尾綜合徵等「紅旗警號」(Koes et al., 2010; van Tulder et al., 2010)。在排除嚴重脊椎病變及特定背痛原因後,可將腰背痛診斷為非特異性,治療重點應轉向功能恢復,特別是通過改善運動控制功能障礙(Motor Control Dysfunction)來緩解疼痛並提升功能。
GBD 2021 Low Back Pain Collaborators. Global, regional, and national burden of low back pain, 1990-2020, its attributable risk factors, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021. Lancet Rheumatol 2023: 5: e316-29.
Koes, B. W., Van Tulder, M., & Thomas, S. (2006). Diagnosis and treatment of low back pain. Bmj, 332(7555), 1430-1434.
Koes, B. W., Van Tulder, M., Lin, C. W. C., Macedo, L. G., McAuley, J., & Maher, C. (2010). An updated overview of clinical guidelines for the management of non-specific low back pain in primary care. European Spine Journal, 19(12), 2075-2094.
McGill, S. (2015). Low back disorders: evidence-based prevention and rehabilitation. Human Kinetics.
Neumann, D. A. (2016). Kinesiology of the Musculoskeletal System-E-Book: Kinesiology of the musculoskeletal system-e-book. Elsevier Health Sciences.
Van Tulder, M., Becker, A., Bekkering, T., Breen, A., del Real, M. T. G., Hutchinson, A., … & COST B13 Working Group on Guidelines for the Management of Acute Low Back Pain in Primary Care. (2006). European guidelines for the management of acute nonspecific low back pain in primary care. European spine journal, 15(Suppl 2), s169.
Wallden, M. (2009). The neutral spine principle. Journal of bodywork and movement therapies, 13(4), 350-361.